Expanded Program on Immunization (EPI)The DRC EPI is in the Disease Control Directorate, Ministry of Public Health (MOPH).

Government Spending on ImmunizationOver the period 2006-2013, the country’s Gross National Income increased from US$230 to US$400 per capita, almost doubling in eight years. According to the WHO/UNICEF Joint Reporting Form (JRF), the government spent $1 on routine immunization per surviving infant in 2006. By 2013, this figure had risen to $2, a doubling of government contributions to routine immunization. While increasing in absolute terms, the government share of total routine immunization expenditures dropped from 9 percent to 7 percent from 2006-2013. Caveats: Reporting for JRF Indicator 6500 is incomplete but is consistent across the other JRF financial indicators. The data suggest that DRC has progressed towards country ownership of its immunization program.

Tracking Expenditure FlowsThe EPI completed the SIF Budget Process Tool in August 2012 and May 2013. By November 2013, the EPI team was meeting independently on a monthly basis to update the Tool. The team met almost monthly until September 2014, when they updated the Tool for 2014. They updated it again in December.

DRC tracks immunization expenditures in the following manner as of December 2014:

Every quarter, the Ministry of Budget (MOB) Budget Manager earmarks each budget line to monitor

The MOPH Deputy Budget Manager and EPI track budget disbursement

At the end of every trimester, financial inspectors conduct a budget accountability mission, the results from which are sent to the Court of Audits

At the end of the year, the government conducts a mission surveying all EPI expenditures, the result from which is sent to parliament

Provincial EPI teams use Form 6, a resource tracking tool used monthly

Domestic Advocacy NetworkIn May 2012, a parliamentary SIF champion completed the charter for the Parliamentary Network for Immunization. The charter sets guidelines for the Network’s structure, purpose, and recruitment procedures. Fifteen MPs joined the Network in June and resolved that its primary role is to conduct continued advocacy in parliament for adequate immunization financing. The Network’s first official meeting was in July and was attended by the EPI manager. In September 2013, the Network defended the proposed EPI budget in parliament. The Network conducted its regular field missions and ad-hoc advocacy initiatives independent of Sabin on three key occasions in December 2014.

As of January 2015, the Network is staffed by MPs, EPI staff, health professionals, officials from Ministries of Finance and Budget, EPI partners and civil society. Network representatives have deputized public and private provincial authorities from 6 of DRC’s 11 provinces to mobilize local resources for immunization financing:

December 2013: Bas-Congo

May 2014: Kasai-Oriental

May 2014: Kasai-Occidental

October 2014: Orientale

December 2014: Bandundu

December 2014: Maniema

Legislation for SustainabilitySection I, Articles 42 and 47 of the Constitution (2006) obliges the State to guarantee the health of every Congolese child.

The DRC government began preparing its draft immunization law by April 2012. The following May, the WHO and Economic Community of Central African States (ECCAS) co-issued an advocacy memo to the President to support the production of the immunization law. At a peer review workshop in November 2012, DRC government officials incorporated amendments recommended by government peers from Congo, Madagascar, Cameroon, Mali and Senegal.

In July 2013, the parliamentary law drafters finalized the first draft law and submitted it to parliament. The following November, the drafting MPs and EPI generated a second draft law per the Parliamentary Legal Advisor’s suggestions and relayed it back to the Advisor.

In June 2014, due to unforeseen circumstances, the law drafters began conceptualizing a general law on health which addresses immunization financing, instead of a stand-alone immunization law. As of November 2014, the MOHP is developing a proposal for the stand-alone law, which the Prime Minister will leverage to encourage parliament to make an exception for the law.